DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

DOUGLASS COMMUNITY SERVICES, INCORPORATED

000672599

(573) 221-1540

661 CLINIC RD
HANNIBAL
MO  63401-3607

DOUGLASS COMMUNITY SERVICES, INCORPORATED

661 CLINIC RD
HANNIBAL
MO  63401-3607

CAPP, ANNA LEE

EHSCLINIC@DOUGLASSONLINE.ORG

Incorporated

BETHANY C DUCKWORTH

6 WEEKS - 36 MONTHS

16

GROUP HOME AND CENTER

 
Inspection Information

08/27/2020

2:03 PM

2:38 PM

ANNOUNCED

SUPPLEMENTAL

2384971964


DocumentDocument-Date
ARTICLES OF INCORPORATION 06/02/2016
APPLICATION 08/25/2020
EQUIPMENT LIST 08/25/2020
CERTIFICATE OF GOOD STANDING 08/25/2020
STAFF SHEET 08/30/2018
FIRE/SAFETY INSPECTION 07/21/2020
SANITATION INSPECTION 06/03/2019
DIAGRAM/INDOOR 09/10/2002
DIAGRAM/OUTDOOR 09/10/2002
SAFE SLEEP POLICY 12/11/2015
LINES OF ADMINISTRATIVE AUTHORITY 04/27/2009
JOB RESPONSIBILITIES 06/15/2005
CHILD CARE PRACTICES 06/15/2005
POLICIES 06/15/2005
SAMPLE WEEKLY MENU 08/28/2001
SAMPLE FORMS 08/28/2001
DAILY SCHEDULE 08/28/2001
OWNER/PROVIDER REFERENCES 07/05/2001
DISCIPLINE POLICIES 03/03/2010
LLC ARTICLES OF ORGANIZATION 05/24/1993
DISASTER AND EMERGENCY PREPAREDNESS PLAN 08/06/2019
LOCAL ZONING APPROVAL 08/28/2008
DIRECTOR'S QUALIFICATIONS 01/30/2020




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 5
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.
Attendance at Time of Inspection
Total Staff 7
StaffChildClass AgeNote
7 0 NO CHILDREN IN ATTENDANCE Staff: Anna Capp, Carla Schoenborn, Heather Stupavsky, Kathy Couch, Kaylee Waters, Shelby Hooper, Sharea Salmon. Center is currently not open with children. Children are expected to return to facility on September 8, 2020.

 
19 CSR 30-62.032 Organization and Administration
Not Observed
19 CSR 30-62.042 Initial Licensing Information
Not Observed
19 CSR 30-62.052 License Renewal
Violation
 Provider Comments
Violation
The sanitation inspection was not conducted.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (1) (B) states: Evidence of compliance with local or state, or both, sanitation requirements;
Correction Required
The facility shall submit evidence of compliance with sanitation requirements for renewal.

Correction Verification
Submit Documentation

Compliance Date

Violation
The Family Care Safety Registry check was not conducted for Kathy Couch and Kaylee Waters within 60 days prior to the expiration of the license.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (2) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within sixty (60) days prior to the expiration of the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all staff member(s) within sixty (60) days prior to the expiration of the license.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not meet requirements for a criminal background check. Results were not on file for board president: Seth McBride (FCSR).
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (3) states: The facility owner(s), board president or chairperson, and the center director or group day care home provider, shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements, prior to renewal of the license.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Not Observed
19 CSR 30-62.087 Fire Safety
Not Observed
19 CSR 30-62.090 Disaster and Emergency Preparedness
Not Observed
19 CSR 30-62.092 Furniture, Equipment and Materials
Not Observed
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
Verification of safe sleep training was not documented and maintained as evidenced by there is no documentation of Safe Sleep training in OPEN Initiative of Safe Sleep training for Katherine Couch.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (4) (A) states: The training shall be documented and maintained as described in paragraph (3)(F)2. of this rule.
Correction Required
Safe sleep training shall be documented and maintained.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.112 Staff/Child Ratios
Not Observed
19 CSR 30-62.122 Medical Examination Reports
Not Observed
19 CSR 30-62.132 Admission Policies and Procedures
Not Observed
19 CSR 30-62.142 Nighttime Care
Not Observed
19 CSR 30-62.152 Hourly Care Facilities
Not Observed
19 CSR 30-62.162 Overlap Care of Children
Not Observed
19 CSR 30-62.172 Emergency School Closings
Not Observed
19 CSR 30-62.182 Child Care Program
Not Observed
19 CSR 30-62.192 Health Care
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by required immunizations verifying the type of vaccine and the month, day and year of administration was not on file for one (1) child(ren).
Licensing Rule Reference
19 CSR 30-62.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.202 Nutrition and Food Service
Not Observed
19 CSR 30-62.212 Transportation and Field Trips
Not Observed
19 CSR 30-62.222 Records and Reports
Not Observed
19 CSR 30-63.040 Background Screening Findings
Not Observed
RSMo 210.115. Reports of abuse, neglect, and under age eighteen deaths — persons required to report — supervisors and administrators not to impede reporting — deaths required to be reported to the division or child fatality review panel, when — report made to another state, when. —
Not Observed
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Not Observed